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CRITICAL APPRAISAL WORKSHEET
AN META ANALYSIS JOURNAL
Authors : Qonitatun Nahdliyyah, Nieko Caesar A. M.
Journal : Risk of Placenta Previa in Second Birth After First Birth Cesarian
Section: A Population-Based Study and Meta-analysis
Journal/Year/Vol./Page: BMC Pregnancy and Childbirth/ 2011/ 11/1-10
A. ARE THE STUDY RESULTS VALID?
1. Did the overview
address a focused
clinical question?
Yes
2. Were the criteria used to
select articles for
inclusion appropriate?
Yes
3. Is it unlikely that
important relevant
studies were missed?
Sampel terpenuhi?
Yes
4. Was the validity of the
included studies
appraised?
Yes
1
5. Were assesments of
studies reproducible?
Yes
6. Were the results similar
from study to study?
Yes
B. WHAT WERE THE
RESULTS?
1. What are the overall
results of the review?
2. How precise were the
results?
C. CAN THE RESULTS BE APPLIED TO YOUR PATIEN(S)?
1. Can the results be applied to
my patient (care)?
Yes
2. Were all clinically important Yes
2
outcomes considered?
3. Are the benefits worth the
harms and costs? Manfaat
cukup baik
Yes
CONCLUSIONS
The results or recommendation are
valid (from A)
Yes
The results are clinically important
(from B)
Yes
The results are relevant to my
practice (from C)
Yes
3
Critical Appraisal Worksheet – Harm/Etiology
Student: Qonitatun Nahdliyyah, Nieko Caesar
A.M.
Date: 09-01-2013
Complete Article Citation (APA format):
Risk of Placenta Previa in Second Birth After First Birth Cesarian Section: A
Population-Based Study and Meta-analysis
Appraisal (be sure to provide your comments - simple yes/no answers normally are
not acceptable)
Are the Results Valid?*
Questions Comments
Were there clearly defined
groups of subjects, similar
in all important ways
other than exposure to the
treatment or other cause?
Yes
Were treatment exposures
and clinical outcomes
measured the same ways
in both groups (e.g., was
the assessment of
outcomes either objective
(e.g., death) or blinded to
exposure)?
Yes
4
Was the follow-up
sufficiently long and
complete?
Yes
Do the results satisfy the
common tests for
causation (e.g., temporal,
dose-response, biological
plausibility)?
Can’t tell
Sejauh ini kami belum menemukan penelitian yang
menjelaskan hubungan sebab akibat yg terjadi antara
riwayat SC sebelumnya dengan kejadian plasenta
previa pada kehamilan sekarang.
What are the Results?*
Questions Comments
How strong is the
association between
exposure & outcome?
P<0,001
95% CI (1,71-2,07)
How precise is the
estimate of the risk?
Adverse Outcome
Present Absent
Exposed to
treatment
CS Delivery 8,7 991,6
Vaginal
Delivery
4,4 995,6
RR = ((a/(a+b))/(c/(c+d))=(8,7/1000)/(4,4/1000)=1,98
How Can the Results Apply to Patient Care?*
Questions Comments
Were the study patients
and their management
similar to mine?
-
What is the magnitude of
the risk/should I stop
exposure?
Untuk mengurangi angka kejadian plasenta previa
maka kejadian SC pd kehamilan sebelumnya juga harus
dikurangi yaitu dengan melaksanakan periksa
kehamilan (ANC) secara teratur sehingga penyulit
5
kehamilan dapat terdeteksi dini
Do the results of this
study fit with other
available evidence?
Yes
Jurnal ini juga merupakan penelitian metaanalisis yang
mengkaji beberapa publikasi dengan tujuan penelitian
yang sama. Hasil penelitian ini dengan uji metaanalisis
yang dilakukan sesuai.
*Question format derived from the following sources:
Guyatt, G., & Rennie, D. (2002). Users' guides to the medical literature:
Essentials of evidence-based clinical practice. Chicago: AMA Press.
Heneghan, C. & Badenoch, D. (2006). Evidence-based medicine toolkit. 2nd
ed. Malden, MA: Blackwell Publishing.
McGibbon A, Eady A, & Marks S. (1999). PDQ Evidence-based principles
and practices. Hamilton, OT: B.C. Decker.
Sackett DL, Straus S, Richardson S, Rosenberg W, & Haynes RB. (2000).
Evidence-based medicine: How to practice and teach EBM, 2nd ed. London:
Churchill Livingstone
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